Hernia

What is Hernia?

Hernia is a condition referring to an organ like your bowel protruding through the wall of a cavity which should contain this organ.

Example, when the bowel protrudes through the groin, we call this groin hernia, or through the umbilicus and we call this umbilical hernia.

Why do I get a Hernia?

The commonest cause for hernia is weakness of the abdominal wall together with increased pressure inside the abdomen, weakness of the abdominal wall can be predisposed by obesity, old age, previous abdominal surgery, repeated pregnancies.

How do I know that I have a Hernia ?

At the very early stage, the symptoms could simply be increasing discomfort, pain in your groin or at the scar of previous surgery with time a swelling will start to show, this swelling often progresses and in some occasions it becomes huge and does result in disabling patient and interfering with normal daily activities. If left untreated, the bowel may strangulate (Due to blood supply cut off), this is life thretening and should be operated within 6 hours or serious consequences will follow.

Can I leave my Hernia untreated ?

While early hernias may be safe to watch, complications can be serious and in some occasions life threatening particularly with hernia containing bowel. If the bowel gets stuck at the hernia orifice, you will need to be rushed to the hospital and have an emergency surgery to avoid death of the bowel. We always recommend an early intervention to avoid serious complications.

I have a lot of medical problems, Am I fit for surgery ?

Hernia operation can be performed on almost every patient no matter what are the underlying medical problems or medications; we simply have to choose the correct modality of surgery. We can operate under General anaesthesia in fit patients, with regional anaesthesia in unfit patients. I have also operated numerous patients under local anaesthesia with an absolutely excellent outcome in patients who are very frail or having significant heart or lung diseases.

How do you repair my hernia?

During our consultation, I will thoroughly examine your hernia, assess your fitness and discuss with you the most suitable approach for your hernia. I can offer you a laparoscopic (Keyhole) surgery which I often use if you have an average size double hernias, I may recommend the classic open approach as it may give the best outcome in certain patients. I will advise you on the type of anaesthesia I will use, general, regional or local. I have built my experience through operating thousands of hernia cases during my career.

I do not like hospitals, How long does it take ?

Most of my hernia operations are done as a day case, you will come to the hospital around 7:00 am, see my anaesthetist, I will see you on the day of your surgery, go through our final discussion and ensure that you fully understand everything. I will examine you for the last time before surgery to ensure that nothing has changed, I will mark your hernia then you will be called to theatre. We will double check you in theatre then surgery will start. This often takes one to three hours depending on your hernia. You will then awake in recovery and move back to your room. I will come to check on you and explain all what we have achieved. While most patients can go home in couple of hours, I tend to keep elderly patients for one night under maximum care to ensure they are up and about, eating and drinking, passing urine and comfortable

Is this operation safe ?

It is extremely important to choose your surgeon, ensure who is operating on your body which is the most precious gift you have. While this is not possible at the public sector, you have the privilege of choosing your surgeon at the private sector. I have operated thousands of hernia operations both at the NHS and at the private sector. I have trained numerous registrars on adopting the best technique to achieve the best outcome. In my hands, I have 0% recurrence rate, 0% return to theatre rate and 0% complications rate.

What happens after surgery and how long is recovery?

The day after your operation you will be able to practice normal gentle daily activity, minor discomfort is expected at site of surgery for the first few days. This often resolves in a week time. I do advise to practice gentle daily activity for 6 weeks after, this includes, walk, gentle swimming, and cycling. I will see you in clinic 6 weeks after your surgery. Check your healing and discharge you. I will advise you to continue to be careful up to 3 months after your surgery. By that time the maximum strength of repair will be achieved and you can now do whatever you wish.

Do you use a Mesh ? I heared bad things about it !

I always use mesh to repair your hernia. This is recommended by the Royal college of Surgeons in almost all hernias. A mesh is a synthetic material that aims at enforcing the area but more importantly stimulating scarring of the defect to ensure a long term effect. Do not worry; this mesh is within the abdominal wall and not inside the cavity. It has nothing to do with the concerns that were raised in the media regarding prolapse surgery in women. This is completely different. You will not be aware of presence of the mesh following healing.

What if I had any concerns months after my surgery?

During our initial consultation, I will provide you with my direct contact details, you will have an open access to contact me via email or via calling my secretary, I am committed to response to all my patient the same day I receive any enquiry. I will advise you on any concern and if needed I will see you again to rest your mind and ensure all is going in the correct direction. The privilege of direct access to your consultant makes all the difference and although it increases my workload, but it ensures that all my patients are receiving the highest standard of care and are looked after as they wish.

Any thing else I need to know ?

If you have any concerns you developed hernia, you can simply book yourself into my clinic for a consultation, you do not actually need to get a referral from your GP but it is advisable to provide your GP details so we can communicate with him following the consultation for accurate health records keeping. You may choose to keep this confidential.

For more details about hernia, please click the link here, this will take you to the patient information section of the NHS.

You can also watch my Hernia presentation here

If you are still in doubt, please feel free to email me here.

Finally, I wish you all the best with your upcoming treatment.

Your Bowel, Your Health